Division of the Budget Landon State Office Building Phone: (785) 296-2436 900 SW Jackson Street, Room 504 adam.c.proffitt@ks.gov Topeka, KS 66612 http://budget.kansas.gov Adam C. Proffitt, Director Laura Kelly, Governor Division of the Budget February 11, 2025 The Honorable Will Carpenter, Chairperson House Committee on Health and Human Services 300 SW 10th Avenue, Room 112-N Topeka, Kansas 66612 Dear Representative Carpenter: SUBJECT: Fiscal Note for HB 2266 by House Committee on Health and Human In accordance with KSA 75-3715a, the following fiscal note concerning HB 2266 is respectfully submitted to your committee. HB 2266 would enact the Advanced Practice Registered Nurse (APRN) Licensure Compact to provide interstate practice privileges for APRNs. Estimated State Fiscal Effect FY 2025 FY 2026 FY 2027 Expenditures State General Fund -- -- -- Fee Fund(s) -- $271,000 $56,000 Federal Fund -- -- -- Total Expenditures -- $271,000 $56,000 Revenues State General Fund -- -- -- Fee Fund(s) -- Unknown Unknown Federal Fund -- -- -- Total Revenues -- Unknown Unknown FTE Positions -- 1.00 1.00 The Honorable Will Carpenter, Chairperson Page 2—HB 2266 The Board of Nursing indicates that HB 2266 would have a fiscal effect on expenditures and revenue for the Board beginning in FY 2026. The Board would be adding four additional license types for APRNs (multistate license in each of the four roles of APRNs). Due to this, there would need to be changes made to the Board’s licensing software, which must be performed by the vendor at a one-time cost of $215,000. The Board would apply for a grant from the National Council of State Boards of Nursing (NCSBN) for the implementation costs but is uncertain if the grant would be awarded. The Board states that it is unknown what the annual membership fee would be for the APRN compact. Due to the increased work of licensing (four additional licenses and more licensing requirements) the Board states that it would need increased expenditure authority of $56,000 from the Board Fee Fund for 1.00 additional position for the licensing division. The total projected expenditure estimate is $271,000 from the Nursing Board Fee Fund in the first year and $56,000 in future years. The Board estimates that it could receive $215,000 from the NCSBN grant which would be deposited into the Nursing Board Fee Fund. If the grant is not received, all expenditures would be from the fee fund. The Board states it is unable to project the reduction of revenue that would begin in FY 2026. The number of APRNs obtaining a license from the Board would decrease as more states join the compact. Even if fees are raised for the cost of multistate APRN license, it is projected the Board would lose revenue. Any fiscal effect associated with HB 2266 is not reflected in The FY 2026 Governor’s Budget Report. Sincerely, Adam C. Proffitt Director of the Budget cc: Jill Simons, Board of Nursing